Experts think Gronkowski will be fine, but players caution against rushing him back

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Though only 24, tight end Rob Gronkowski already has taken a lot of hits in his career, so the Patriots are expected to be cautious with his return from back surgery.

By Ben Volin
Globe Staff
June 09, 2013

Ross Tucker was told about the 12-week recovery period, too, when he underwent surgery for a herniated disk in his back in 2005.

Tucker, a seven-year NFL offensive lineman, played through the injury the season before, but finally decided in April to undergo surgery. And sure enough, he was in pads and ready to go for the first day of training camp with the Bills in 2005.

Many medical experts believe that Patriots tight end Rob Gronkowski can be ready to take the field about 12 weeks after he undergoes surgery to repair a herniated disk this month. But there’s a difference in being ready to play and having full confidence restored. Tucker was cut by the Bills at the end of camp in ’05, and never started another NFL game.

“The truth is, it was a full year before I really felt good, and I never felt 100 percent again,” said Tucker, now an analyst and host with NBC Sports and SiriusXM Radio. “I played three years after my surgery, but I was just a little bit less explosive. I never felt like my back was brand new.”

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The good news for Gronkowski, who is having the surgery performed in Los Angeles in mid-June by noted surgeon Robert Watkins: Most empirical evidence suggests that he can return to his elite level of performance, even in the 2013 season.

Gronkowski played through the injury all last season, starting 11 games and catching 11 touchdown passes before being sidelined with a broken forearm. And Gronkowski has returned from this injury before, becoming an instant star as a Patriots rookie in 2010 after missing the 2009 season at Arizona following surgery for a herniated disk, called a “diskectomy.”

“It’s a very, very common procedure,” said Dr. Christopher Bono, chief of spine service at Brigham and Women’s Hospital. “The chance of return to play is actually quite good, and there’s a 90-95 percent chance he’ll go back to playing at full capacity.”

The bad news, though: Patriots fans might have to wait a little while to see their star player this fall — perhaps as much as the first half of the regular season.

He’s also already undergoing his second diskectomy at just age 24 — though his agent, Drew Rosenhaus, said this injury is to a different disk.

And while the surgery is routine, getting Gronkowski back to the point where he can regularly slam into defenders without issue certainly isn’t.

“Offensive and defensive linemen — and Gronk is included, because he does some blocking — are at the greatest risk for developing a poor outcome after this kind of surgery,” said Dr. Wellington Hsu, associate professor at Northwestern University’s Feinberg School of Medicine. “They play the game in a squatting position, and have a lot of force on their back when they hit 300-pound defenders.”

The spine has 26 vertebrae, and in between each is a “disk,” with a hard exterior and gel-like substance in the middle, that serves as a shock absorber. A herniated disk occurs when there is a rupture in the tough outer shell, and the gel seeps out and irritates the nerve, causing intense pain in the back and often numbness in the leg.

“It was the most annoying thing I’ve ever experienced,” said former Patriots linebacker Willie McGinest, who had surgery before the 2001 season and is now an analyst with NFL Network.

Most non-athletes avoid surgery and let the disk heal naturally over 1-2 years, and many NFL players are able to play through the pain, as Gronkowski did last year. Tucker noted that he played in 16 games with his herniated disk in 2004, but only with the aid of painkillers, muscle relaxers, and an anti-inflammatory injection before each game.

‘It’s a very, very common procedure.’

Gronkowski is opting for surgery now only as “preventative maintenance,” Rosenhaus said, and waited until June because he needs the infection in his surgically repaired forearm to clear first.

Watkins, who also performed Gronkowski’s first diskectomy, is also regarded as one of the best in the business. Watkins repaired the herniated disk of Giants star pass rusher Jason Pierre-Paul just last week, and the Giants hope to have him back by Week 1.

“He’s the forefather of disk herniation in pro athletes,” said Hsu. “He has done more of these surgeries on pro athletes than anyone in the world.”

The generally accepted recovery period after surgery is 12 weeks — six to let the scar heal, and another six to get back into football shape. Gronkowski likely won’t be allowed to do so much as lift a 5-pound dumbbell until the end of July, at the earliest.

As Gronkowski noted in 2009, three weeks after his first back surgery, “I sit at home eight hours a day playing video games in the recliner.”

Once the scar is healed, he needs to get back in football shape — which means a lot of work to his core and making sure he can withstand the pounding of football.

“With professional football players you may have to wait a little bit longer because of the intensity that they’ll play, but generally within six weeks, he should be at a level that is probably close to full capacity,” Bono said.

But many players who underwent a similar surgery dispute the notion that they were 100 percent and ready to play after 12 weeks.

“I was put into training camp four months off of back surgery, which was completely asinine,” former offensive tackle Kyle Turley said of returning from his back injury with the Rams in 2005. Three days later, he re-herniated the same disk, and had to schedule a second surgery, which cost him the season. “In the middle of practice, boom, it hit me. I walked off the field, sat down on the cart. I knew I shouldn’t have been out there.”

And doing core exercises with a trainer is much different than replicating live football and being smashed by 300-pound defenders. Former Steelers Pro Bowl tackle Marvel Smith returned to training camp 10 months after his disk surgery, but suffered a second herniation five games into the season, which ultimately ended his career.

“In training camp my core was still strong, but my endurance wasn’t there like it should have been,” Smith said. “A lot of stuff that we do is twisting and torquing, and his body is going to get caught in awkward positions.

“I tried to come back, but my body just wasn’t the same. Everything that came naturally to me my whole career, I had to think about doing it.”

Of course, every player is different. Pro Bowl pass rusher James Harrison had two surgeries in 2011, and somehow returned to the lineup six months ahead of schedule, finishing the season with nine sacks in 11 games. Former Broncos defensive end Trevor Pryce missed most of the 2004 season, but played six seasons thereafter. McGinest made the Pro Bowl two years after his surgery. Bears guard Chris Williams had surgery in August 2008, played in the final nine games of that season, and started all 16 the next season.

Then there are players like Smith, Tucker, and Turley, who were able to return to football but never felt 100 percent, and were soon out of the league.

That Gronkowski is only 24, has already once returned successfully from this surgery, and will be under the watchful eye of Watkins and Patriots rehab coordinator Joe Van Allen, all work in favor of him returning — eventually — to a high level.

“Doctor Watkins did a phenomenal job, gave me a great rehab program along with Joe Van Allen,” McGinest said. “It’s just all about how much you put into the rehab, and how much you do, which is going to determine how fast and strong you get back.”

But many expect the Patriots to be overly cautious with Gronkowski, arguably the most important player on the offense behind Tom Brady. The 12-week schedule would put Gronkowski’s return around mid-September, but a stint on the physically unable to perform list — in which he would be forced to miss the first six games of the regular season — is a distinct possibility.

“If they’re smart — and I think that they are — he’s starting the year on PUP and we’re not seeing him until Week 7 at the earliest,” Tucker said.

“That kid has got a chance at a 15-year, Tony Gonzalez-type of career,” Turley said. “Let him get fixed, come into the season late. So what? Make your push at the end, you’ve got other people.”

Gronkowski fell in the 2010 draft because of his back issues, and will likely have a proclivity to suffering this type of injury for the rest of his life. But it’s not unreasonable to expect him to return to his dominant self and play another decade.

“I’d be a lot more worried about the forearm than I would be about the back,” Hsu said. “He is predisposed to getting another disk herniation, just from his history, but for that I wouldn’t have a poor prognosis for recovery. I would just recognize that he does have back issues and to keep an eye on him after he recovers.”